New York Medicaid policy covers transgender-related health care.

Regulations:

• 18 NYCRR 505.2 (2016)

Decisions:

• Court Decision:  Cruz v. Zucker, 195 F. Supp. 3d 554, 571 (S.D.N.Y. 2016), on reconsideration, 218 F. Supp. 3d 246 (S.D.N.Y. 2016), and appeal withdrawn, (Dec. 30, 2016)
  Summary:

  A federal district court found that a categorical ban on medically necessary treatments for a specific diagnosis, gender dysphoria, violates the federal Medicaid Act’s Availability Provision.

Guidance and Announcements:

• Guidance:  New York State Department of Health, Office of Health Insurance Programs, Criteria Standards for the Authorization and Utilization Management of Hormone Therapy and Surgery for the Treatment of Gender Dysphoria

Handbooks and Provider Manuals:

• Provider Manual:  NYS Medicaid Physician Procedure Codes - Surgery